Fentanyl makes an already dangerous drug market deadlier than ever

by BRYCE PARDO & DAVID LUCKEY

More than 100,000 Americansdied of a drug overdose in 2021 – double the number of deaths in 2015 and more than the number of deaths inguns and car crashes combined. Drug overdose is now theleading cause of death among people aged 18 to 45.

This tragedy has been going on for decades, but since 2014 it hasgreatly worsened.This year,dealers and traffickers began smuggling in illegally manufactured fentanylin the market, first hiding it as heroin, and finallysqueeze it into tabletsmade to look like real prescription drugs.

We will not be able to simply stop, seize or process our way out of this crisis. A new strategic approach is needed.

Many of the same characteristics that make fentanyl an attractive drug for Mexican illegal suppliers and traffickers can make it a death sentence for users. As a synthetic opioid, fentanyl is not made from poppies, but chemicals from large industrial chemical sectors in China and India. It is cheap and easy to produce. By weight, fentanyl isup to fifty times more potent than heroin, which means that it takes very little to meet the US demand for opioids. Maybe a few truckloads of pure fentanyl are needed to supply our country for an entire year.

Street drug use has always been risky, but today’s level of risk is simply unprecedented. Many traditional drug policy goals have focused on raising the price of drugs sold illegally through seizures; reduce the demand for drugs through prevention programmes; or the promotion of treatment to bring those who use drugs into rehabilitation. In all cases, the emphasis has been on reducing the population of drug users, either indirectly, by reducing their consumption through high prices, or directly, by switching users to drug treatment programs. substance addiction.

The United States must work with the two main suppliers of the chemicals needed to make fentanyl, China and India, to stem the flow of precursor chemicals needed to produce it.

But we won’t be able to simply stop, grab or process our way out of this crisis. A new strategic approach is needed, which has motivated the formation of a joint legislative-executive branchSynthetic Opioid Trafficking Commissionin 2020. The bipartisan Commission was guided by a goal of saving American lives.

The Commission’s report includes recommendationsthat the United States must work with the two main suppliers of the chemicals needed to manufacture fentanyl – China and India – to stem the flow of precursor chemicals needed to produce it. But even if a disruption in the flow of needed chemicals is successful, it could be short-lived if traffickers in Mexico find new sources of the chemicals. Nevertheless, increased efforts to improve oversight of major chemical industries in Asia are needed to reduce the availability of many common chemicals used to manufacture drugs illegally. Possible supply disruptions, even temporary, could save lives.

That said, in the long term, synthetic opioids are likely to increasingly reach illicit drug markets. Failure to recognize and respond to how quickly these markets have changed with the arrival of illegally manufactured synthetic opioids will continue to put many Americans at risk of exposure to fentanyl, putting the lives of hundreds at risk. thousands more for years to come.

Some people who overdose on fentanyl, for example, don’t even have what we traditionally think of as a “drug problem” – they can just take it once, in fake pill form, so our usual responses in drug treatment cannot help them. And many of those whowould like toreceiving treatment cannot do so if they die suddenly after mistakenly consuming fentanyl concealed in heroin or cocaine. Although efforts to reduce drug supply and demand are necessary, they alone are no longer sufficient to stem the increase in overdoses.

The Commission found that while it is necessary to tackle the supply chain, it is also vital to support national efforts to reduce the harm caused by these drugs. Changing messages around drug use should also be considered. Such messages could raise awareness of the presence of fentanyl in the drug supply, which in turn could encourage individuals to use street drugs with a trusted friend. Messaging could also better describe ways to dose more carefully or slowly, which could also help reduce the risk of a fatal overdose.

All of this will require cooperation across the federal government and coordination between all levels of government, as well as with non-governmental organizations. It’s just what it takes to save lives.

Bryce Pardo is the Associate Director of the RAND Drug Policy Research Center at the nonprofit, nonpartisan RAND Corporation; David Luckey is a senior international and advocacy researcher at RAND and a professor of policy analysis at Pardee RAND Graduate School. Both served on the staff of the Synthetic Opioid Trafficking Commission.

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